Background: Patellar malalignment is a risk factor of patellofemoral pain. Evaluation of the patellar alignment have mostly used magnetic resonance imaging (MRI). Ultrasound (US) is a non-invasive instrument that can quickly evaluate patellar alignment. However, the method for evaluating patellar alignment via US has not been established. This study aimed to investigate the reliability and validity of evaluating patellar alignment via US.
Methods: The sixteen right knees were imaged via US and MRI. US images were obtained at two sites of the knee to measure US-tilt as the index of patellar tilt. Using a single US image, we measured US-lateral distance and US-angle as the index of patellar shift. All US images were obtained three times each by two observers to evaluate reliabilities. Lateral patellar angle (LPA), as the indicators of patellar tilt, and lateral patella distance (LPD) and bisect offset (BO), as the indicators of patellar shift, were measured via MRI.
Results: US measurements provided high intra- (within-day and between days) and interobserver reliabilities with exception of interobserver reliability of US-lateral distance. Pearson correlation coefficient indicated that US-tilt is significantly positively correlated with LPA (r = 0.79), and US-angle is significantly positively correlated with LPD (r = 0.71) and BO (r = 0.63).
Conclusion: Evaluating patellar alignment via US showed high reliabilities. US-tilt and US-angle showed moderate to strong correlation with MRI indices of patellar tilt and shift via MRI, respectively. US methods are useful for evaluating accurate and objective indices of patellar alignment.
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http://dx.doi.org/10.1016/j.jos.2023.02.020 | DOI Listing |
Arthroscopy
December 2024
University of Virginia Health System, Department of Orthopaedic Surgery.
Purpose: To describe the clinical and radiographic outcomes of patients undergoing a lateral opening distal femur osteotomy (DFO) to address valgus alignment and restore patellar stability.
Methods: A retrospective review of patients who underwent lateral opening DFO for recurrent patellar instability in the setting of valgus leg alignment at a single academic institution between January 2016 to December 2021 was performed. Patients without a minimum 24-month postoperative follow-up were excluded.
Knee Surg Sports Traumatol Arthrosc
December 2024
Department of Orthopaedic Surgery, Western Health, Melbourne, Australia.
Purpose: Lateralisation of the proximal apex of the quadriceps tendon relative to the mechanical axis or external rotation relative to the femoral shaft can be accurately measured and is strongly associated with patella maltracking. The aim of this study was to first assess the association between preoperative quadriceps tendon alignment (QTA) and the patient-reported outcomes (PROMs) of total knee replacement, and second, determine the influence of component position on outcomes in patients with preoperative quadriceps tendon malalignment (QTM).
Methods: A retrospective analysis of prospectively collected data was performed.
Arch Orthop Trauma Surg
December 2024
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Introduction: This study aimed to compare the differences in the radiological, clinical, and functional outcomes and the estimated restoration rate of native knee alignment between total knee arthroplasty (TKA) with bi-cruciate stabilized (BCS) and posterior stabilized (PS) design.
Materials And Methods: This retrospective study included consecutive patients between 2020 and 2021 who underwent TKA. The patients were divided into two groups (group I, Journey II BCS TKA [106 knees]; group II, Persona PS TKA [106 knees]) after 1:1 propensity score matching.
Arch Orthop Trauma Surg
December 2024
Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, 26 Kyunghee-daero, Dongdaemun-gu, Seoul, 02447, Korea.
Purpose: To compare the complication rates between deficient patellae (remnant patellae after component removal) and non-resurfaced patellae after 1.5-stage exchange arthroplasty for periprosthetic joint infection and identify risk factors for complications of deficient patellae.
Methods: Complications in 76 deficient patellae (group D) and 41 non-resurfaced patellae (group N), with a minimum follow-up of 2 years after 1.
Rev Esp Cir Ortop Traumatol
December 2024
Department of Traumatology and Orthopedic Surgery, Clínico San Carlos Hospital, Madrid, Spain; Surgery Department, Complutense University, Madrid, Spain.
Introduction: Achieving stability in total knee arthroplasty (TKA) is crucial for long-term implant survival. In cases of severe deformity or ligament laxity, constrained implants may be required. Traditionally, increasing constraint involved intramedullary stems.
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